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In this episode of When Work Hurts, I’m joined by Consultant Clinical Psychologist Dr Sarah Swan to talk about her experience of breast cancer and how becoming a patient affected her both personally and professionally.
Sarah shares the story behind her book Coping with Breast Cancer, and we explore the emotional realities of cancer diagnosis and treatment – including fear, uncertainty and the pressure created by some of the familiar cultural narratives about how people are supposed to cope with cancer.
We also talk about what it is like to navigate serious illness while working as a psychologist. Sarah reflects on decisions about what to tell clients, the complexities of self-disclosure and professional boundaries, and how her experience challenged and reshaped aspects of her professional identity.
Our conversation explores the role of values when life becomes uncertain, what psychological skills can – and can’t – offer when you are living through your own difficult experience, and what it feels like to encounter healthcare professionals from the other side of the consulting room.
Finally, Sarah shares some of the things she wishes health professionals understood about supporting people through cancer, and we discuss the wider Coping with… book series and its aim of providing accessible, psychologically informed support for people facing difficult life experiences.
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The Coping With series is available via Sequoia Books and Routledge. ACP-UK members receive a discount on all ACP-UK titles – details are in the monthly members’ newsletter, The Buzz.
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Transcript
Paula Redmond (00:04)
Hi, I’m Dr. Paula Redmond, and you’re listening to the When Work Hurts podcast, which is brought to you by the Association of Clinical Psychologists, the representative professional body for clinical psychologists in the UK. In this series, I’ll be exploring the intersection of the personal and professional through conversation with clinical psychologists who have written about challenging life events and circumstances that they faced in the Coping With book series. We’ll be thinking about how these experiences affected them as professionals and how their professional roles and identities have intertwined with these challenges, as well as the wisdom, expertise and guidance they’ve shared with readers.
Kicking off the series is Dr Sarah Swan, consultant, clinical psychologist and editor of the Coping with book series. Sarah has written about coping with breast cancer following her own diagnosis at a particularly challenging time professionally. She shares how she navigated this as well as the psychological skills and strategies she drew on to support her through treatment.
Well, welcome Sarah. Thank you so much for joining me today. And we’re here to talk about your great book, which is part of the Coping With series from the ACP, and it is called Coping with Breast Cancer. And you’re also the series editor, which is great. So I wonder if we could kick off with just you explaining how you came to write the book and how the series itself came about.
Sarah Swan (01:44)
Yeah, sure. Well first of all, thank you very much for having me and the other authors on. It’s really exciting to talk to you having listened to the podcast so much. So yeah, so the book, I kind of had always had in my mind this idea that I might like to write a book, but had no idea what I would write a book on and didn’t feel I had expertise in any kind of clinical area that I might write on that. So I never ever thought this would be a thing. And then it was literally the first week that I’d received my breast cancer diagnosis. I was lying in bed and couldn’t sleep and just had this urge to get up and write about what I’d been through over those last few days. And at the end of that, which I found, you know, really helpful, I had this kernel of an idea that maybe this could be a book. I had this sort of awareness, I guess, that I had, I was going through this really challenging experience, but I also had my professional skills that I could draw upon. And I wrote a little note at the bottom, like maybe this could be a book question mark? And I thought I must keep writing as I go through this. I didn’t actually. I never felt the urge to again after that. I think there was a lot of avoidance going on, if anything. But I was a director for the ACP UK at the time, and they partnered with Sequoia Publishers and on the board we had a discussion one day about just wanting to kind of brainstorm some book ideas. So I had a long conversation with myself where… or with my imposter who was saying, well of course this is a rubbish idea and yeah no one’s going to think that’s a good idea and what do you know about writing a book? But I took that brave step to pitch the idea, which was very well received by Annabelle Kurtz, who was the director of operations of ACP at the time, and a publisher. So then I had to actually put together a proper proposal and start thinking about it. And I think it was during that process that I suddenly thought, well, actually, there’s clinical psychologists out there going through all kinds of life experiences. And maybe this could be a really helpful series. So again I put that back to them and yeah, they were delighted with the idea. So we went out to our members to say, hey, would anyone else like to contribute here? And I wasn’t expecting much of a response to be honest. And I was kind of inundated. It was really, really exciting. And of course, not all of those ideas have come to fruition for various reasons, but it’s fantastic that we’ve got so many out already and still more in the pipeline. So yeah, it sort of feels like it’s come about really quite by chance, but it’s, you know, probably gonna be the thing that I’m most proud of in my career, maybe, yeah.
Paula Redmond (04:55)
Yeah, it’s fantastic. I think what I really love about it, and it’s been so like such a great opportunity to be able to do this series and get to read all the books because I just love the ethos around, you know, breaking down the the kind of personal professional barriers and and, you know, clinical psychologists and, you know, health professionals generally obviously being people at the same time. But that, you know, it doesn’t always like land. And it can make it really hard for us as professionals, you know, going through these really difficult things when we might have the sense of, you know, needing to know what to do and how to cope and making it hard to seek help if you’re a helper professionally. So I love it from a sense of, you know, clinical psychologists being open about their humanity and their experience, but also just the wealth of wisdom that is there on offer and that coming from a clinical psychology perspective, which is not really common. So yeah, it’s really fantastic.
Sarah Swan (06:04)
Yeah. And we’ve grappled with the title of ‘Coping With’ on several occasions ’cause, you know, we’ve all gone at some point, but we don’t think we did necessarily cope that well, or are we coping or, you know, and there tends to be coping is thought of as a kind of a thing that you’re doing well or not doing well, whereas we’re, we were all just finding our way through our struggles and but yeah, we kept it as Coping With because, you know, the layperson isn’t gonna pick up a book on, you know, how we didn’t cope very well, muddling through.
Paula Redmond (06:42)
Yeah. But that is such a good point ’cause that’s often a conversation that I have with like, clients about, you know, help me cope with this terrible, awful thing that’s happening in my life and have to think, well, what does that look like? What does coping with like the hardest thing that’s ever happened to you? Like what are you expecting of yourself in this time?
Sarah Swan (07:04)
And I think that you know, as I went through my cancer treatment and I had incredible treatment through the NHS, through COVID, and yeah, I sort of really can’t fault the medical treatment I received. But what I was struck by was that there was very little inquiry actually as to how I was coping emotionally with it. And whilst some of the breast cancer nurses I saw were absolutely lovely, and they were kind and compassionate, but I sometimes felt a bit judged by my strong emotions. I cry quite easily. And I lost count of how many cups of water I was brought that I didn’t want, but it felt like the other person couldn’t sit in the room with my distress. You know, at the end of treatment people kind of expect you to be okay at that point, you know, well done, you’ve got through it, you must feel so relieved. You must feel great. Actually, no, I felt like that’s when it hit me the most in some ways. Because up until then I was having to do quite a bit of avoidance just to cope with the physical grueling treatment. And yeah, so I was left feeling, you know, gosh, I could see what an emotional impact it had on me, but also that the message I was receiving through my healthcare professionals was often that that wasn’t okay in some way, that wasn’t to be expected. So I really wanted to share that these strong emotional reactions are absolutely understandable.
Paula Redmond (08:52)
I think what I really liked about your book was so it kind of takes us through your journey in chronological order. And it’s written in like a very kind of accessible, like matter of fact kind of way, like very open, very kind of spelling it out, you know, sort of, but it was so moving. There’s just something about you articulating these experiences and and the kind of just all the little details about, you know, how it was with your family and your kids and it was very moving. So you did such a great job of this, you know, being able to, I think, articulate very complex experiences in a very simple, human, accessible way. So I really, yeah, felt like, and I kind of read it in one day. It was very very readable too, which is, you know, but I think just was able to hold both that kind of sort of something about the just that kind of ordinary humanity that was, you know, really part of the story, but alongside your your clinical wisdom and your weaving in particularly acceptance and commitment ACT skills that supported you along the way. So I thought it was a great job of book writing because it was like so good to read, but also, you know, full of really useful advice and…
Sarah Swan (10:25)
Yeah, we really wanted the series to be kind of practical, to come away with practical coping skills, whilst also acknowledging none of us cope perfectly, yeah.
Paula Redmond (10:38)
So I wonder if I could just kind of delve into a little bit more about your own experience and some of the things that you talk about in your book. And particularly for this podcast, I’m really sort of curious about how these experiences interacted with your professional identity and role and work. So I wonder if we could think about how your experience of having breast cancer, what that meant for your professional role and identity. And I know it kind of came at a really transitional career point for you.
Sarah Swan (11:17)
Yes, so yeah, a word of warning to those working in private practice, get critical in illness cover. So yeah, so I’d been through quite a tricky period in my NHS career. I then changed trusts so I was head of psychology for Croydon, within South London and Maudsley Trust, but really felt like actually I was a bit burnt out from the NHS, and I’d started doing a bit of private practice a few years before and actually found that I was really enjoying it. And so I made the decision that I was going to take that leap and very sadly leave the NHS because I always thought my career would be in the NHS. But I was really excited as well about this prospect of leaving behind what had been quite a, you know, tough and challenging environment for a few years. But two weeks after I resigned, after I handed in my resignation, I got my breast cancer diagnosis, which, you know, was just awful timing because I just I hadn’t put in place anything like critical illness cover yet. And I had a two hour commute each way to that job and I just immediately felt like I just can’t cope with that because I knew I’d have two hours of being in my own head thinking about my cancer. And I also just felt like I was sort of having to work on service redesign stuff there. And I just felt like I can’t hold that kind of complex information in my mind and, you know, think creatively about that kind of stuff when I’m going through this. So I actually went off sick from that role. So I didn’t go back. But I did still have to earn some money whilst going through treatment. So I did have to keep my private practice going to some extent. But I also realized that actually work was really important to me. My, you know, my identity as a clinical psychologist is really important to me. And work, you know, work in a way that is, you know, fulfilling and kind of sustains you rather than drains you, I found was, you know, really helped me get through the journey. It gave me some normality and this ability to kind of, you know, put on that professional mask, go about my professional day. You know, I would maybe just have a couple of clients in a day. And whilst I was in the room with them, I was absolutely focused on them and their stuff. And it actually was quite a nice break from my own stuff. So that I felt I could do. And as I say, I needed to as well financially. So it was tough at times going through chemotherapy. I was having that every two weeks and I would have a week off. And then the week that I was feeling a bit better, I would have to be working that week. And I was also working for the ACP too, which was great because a lot of you know, most of that was remote and it was really flexible. So that was really good. Yeah, I think the other major thing was, you know, knowing I was gonna have chemotherapy, knowing that I would likely lose my hair. I knew this was going to be something that was going to be visible to my clients. And because I wasn’t just saying I’m going off sick for a few months and be quite vague about what that was about, I felt I had to be quite open with people actually. So I did tell my clients that I had breast cancer, what treatment I was going to have. I said, you know, I really didn’t know how available I was going to be for them because I didn’t know how I was going to respond to the chemotherapy. And so I offered to help them find another psychologist or to stay with me if they were happy with that kind of uncertainty. And actually, they all chose to stay with me, which was really impactful actually. But then it was, you know, I had to be very mindful. Of course, they were inquiring about me and wanted to know how I was each time they saw me. So I had to give a kind of answer that felt authentic enough whilst not leaving with them with something that was going to make them worry about me and then very much bring the attention back to them and make sure, you know, that the session was about them. And I had one client at the time who’d experienced a significant trauma who she sort of said from time to time, ‘but you know, it’s not as bad as what you’re going through’. And you know, that was part of a general pattern for her of minimising her own experience. So yeah, obviously I kind of made those kind of reflections, but also at one point had to say, ‘look, do you know what, I don’t which I’d choose out of your trauma or mine to be honest’.
Paula Redmond (16:22)
So I’m curious as well, Sarah, because that sounds like a really, you know, tricky boundary to hold there around, you know, how you can be authentic with your clients but at the same time, you know, holding their need in mind and balancing that. Were they kind of decisions that you made around, you know, maybe the type of clients that you took on or like how you set things up for yourself to support you in that?
Sarah Swan (16:51)
Yes, yeah. I think I was very mindful of what kind of clients I took on. I probably didn’t take on many new clients during that period. And you know, I’ve never worked in health psychology, I’ve never had that as a particular interest. So I had to fight that imposter whilst writing the book. And while some people might go through a life experience like this and then want to work clinically in that area, I never have. And I still feel it’s a bit too close to my own stuff to see people who are going through breast cancer. So that’s been a bit tricky in terms of kind of promoting the book, you know, because I don’t want to put myself out there as the kind of the breast cancer psychologist because I don’t want those clients coming to me, although I do have an associate, well all my associates would probably take someone with breast cancer, and I’ve got someone who does have an interest in that. Yes. So I’m quite mindful still, in that, in that regard. But I, you know, it does still come up. I’ve got a client at the moment who has a family member who’s just passed away from breast cancer, so it still does come into the room and I’m always careful to take that to supervision and to really think about, you know, is this impacting me? It makes you aware that sometimes you can’t pick and choose and not know if something is ever gonna come up. But I think, yeah, you’ve just gotta reflect on how that’s feeling for you, whether you feel you’re able to show up for the client in a way that’s most helpful for them.
Paula Redmond (18:24)
Yeah. And supervision, I guess, being really useful. And what about decisions around taking time off? Because that’s really tricky. And I guess, you know, that is different if you’re working, if you’re employed, if you’re working in an NHS context where, you know, in some ways it can be easier because you don’t have to think about the financial side.
Sarah Swan (18:27)
Yeah, yeah. Yeah.
Paula Redmond (18:49)
But I know people struggle with the idea of letting colleagues down or you know, there can be kind of punitive processes around sick leave as well in the NHS. But there’s other things to think about, I guess, when you’re in private practice, and how hard you know, you’re the only one who is there to make that decision. How was that for you?
Sarah Swan (19:09)
Yes, exactly. So it’s really tricky, isn’t it? And I, the years before I had had, one of my team had had breast cancer and she continued to work throughout and I remember thinking, gosh, I don’t know, I don’t know how she’s doing it or what you know, really why she’s doing it, although she was telling me, ‘no, and no, I feel it’s good for me to come to work’, but I was thinking, well, if it was me I’d just go off sick for a few months, you know. But actually then when I went through it myself I was like, no, I can see exactly actually, how she felt. And I think, you know, I mean it was quite a battle for me to get the approval to go off sick from my NHS job but still work privately. For me the two were very different. And as I say, I felt like doing my clinical work, which was ten minutes from home, was an hour or two a day.
Paula Redmond (19:56)
Yes, I see. Yeah, you’ve got all the kind of autonomy around how you set that up and…
Sarah Swan (20:11)
Yeah. And I felt that was gonna be good for me. So yeah, I think it’s important in a work context. But I think, kind of sick leave and stuff has probably got tighter since I was in the NHS and and you know, so I’d love to say, well, I think, you know, think about what’s going to be most helpful for you and help you cope the best. But there is that very practical side. Sorry, I don’t know if that’s answered…?
Paula Redmond (20:41)
Yes, yeah, it has.
Sarah Swan (20:44)
But yeah, in private practice, yeah, I was very conscious of how helpful it was that I already had some work that was not around client contact, that was remote, that gave me that.
Paula Redmond (21:00)
The non-clinical work. Yeah. So you had a diversity in your work that meant that not all was dependent on…?
Sarah Swan (21:09)
Exactly. Yeah. And I had supervision clients as well. So, you know, that’s a bit easier to navigate.
Paula Redmond (21:17)
And I know that when you described your treatment in the book around like there were some kind of patterns around like you could sort of judge when you might be feeling well enough to work once you knew how it was. Were there times when, you know, that was difficult? Like when it was hard to judge whether it felt like that kind of like, what is good for me to do the work or to not do the work?
Sarah Swan (21:44)
Definitely. There were definite days when I would really have rather stayed in bed, but you know, and you know, rest is obviously really important, but yeah, so it was always a yeah, whilst staying in bed for a bit longer probably would have been helpful, staying in bed for the whole day probably wouldn’t have been. And on the whole I just felt getting up, getting dressed, putting on that mask was the most helpful thing. But, you know, I had a very limited caseload.
Paula Redmond (22:16)
Yeah. And I mean you’ve touched on, interesting to hear your thoughts on kind of, you know, post that experience, what still with you, I guess, that sense of being cautious about the clients you take on, that your note about, you know, critical illness cover. Top tip. Any other ways you think that this experience has kind of changed and impacted your professional identity?
Sarah Swan (22:48)
I think the whole self disclosure aspect has been major for, you know, for me, for the other authors in the series. I mean ACP have supported us to have a kind of reflective space whilst writing these books. We really wanted to support new writers and that awareness that this was a different kind of book and people really needed that kind of space to support them through it. And it’s been really invaluable. But yeah, month after month we’ve come back to the sort of self-disclosure and those, that dilemma of how much do I share? How much do I need to share for the reader to, you know, understand and for it to be useful for them. But equally, what do I risk in that disclosure, you know, for myself, for you know, talking about family members perhaps. And so it’s been a major discussion point throughout, and we’ve all had to grapple with what feels right for us. And again, there’s been differences for people who work in the field that they’re writing about or not, you know. But it’s certainly, I think, made me use self disclosure more, still very, you know, carefully and in a thought through way. I mean, I guess that’s also changed in that since I used to rent a room and now I’ve got a garden office so people come to my home. So that brings a different dynamic as well. So people already see a lot more of you by coming to your home environment. Yeah, so I would say I do use self disclosure more than I used to. But I don’t tend to disclose my breast cancer actually, although it’s on my website. And I’ve had the occasional person who’s come and has known about it. So then I would obviously be happy to talk about it in the way that I talked about it in the book, but again making sure that that’s not interfering with their experience of the therapy.
Paula Redmond (24:56)
Yes. Yes, it’s really interesting ’cause I guess in training that’s something that’s always well, I suppose I left training with a sense of that being like a really bad thing to do.
Sarah Swan (25:06)
Exactly. Yeah. Yeah. Exactly.
Paula Redmond (25:08)
But I think, and I didn’t do ACT training in my training, because it probably predated ACT being, you know, the having the evidence base, etc. But since being trained in ACT and using ACT and CFT as core models, it’s that is much more possible and I think available to you within an ACT model. I think the training often embodies that, you know, how self disclosure can be used in the service of the client and this real kind of common humanity sort of message be important and helpful.
Sarah Swan (25:46)
Exactly. Yeah. And actually I’d, when I was trained in ACT within the NHS, that came at a time when I was having a really tricky, I was in a quite tricky situation at work, quite tricky context. And actually I immediately started to use it on myself in relation to that and found that so helpful. And it was doing that kind of values piece that helped me to recognise actually, although I always thought I was working in the NHS because that was around my values, whilst it is for you know, I truly believe in the NHS, but actually I found I was having to work in a way that was really in conflict with my values much of the time. And it enabled me to say, okay, this probably isn’t good for me. And no wonder I’m feeling so drained and distressed by my work because I’m not able to work in a way with clients, I’m not able to work with my teams in a way that fits with my values and how I want to show up for people. And so whilst I use other models as well in my practice, that was what I came back to when I got my breast cancer diagnosis and just yeah, the idea that your values act as a compass point, it did really help me kind of navigate through that and you know, focusing on those small things that I could do in line with my values. So like, you know, spending ten minutes with my son playing a game of cards or something, you know, when I was plagued with those thoughts of what a terrible mother I was being. But that helped me just take those opportunities when I could to engage with them and have fun and show up how I wanted to show up as a mum, whereas most of the time I was aware I was not doing that and that was really tough.
Paula Redmond (27:53)
And did you kind of do that consciously? Were you like, ooh, some ACT would be good right now?
Sarah Swan (28:01)
I think I did when I was first trained in it in the work context. Yeah. And I often share an example with clients of how I had a tricky decision to make at work about whether to disclose some information to my team or not, but I was being told not to. So I had my two hour drive to think about what I was gonna do and I was still really perplexed. I was like, I’m gonna get out my values cards and I did the values exercise in relation to that particular decision and I was like yes, that’s really clear. I’m going to share it with them because I’m about being authentic and that’s what’s most important to me and I’ll take the repercussions if they come my way afterwards. But I think yeah, at times it was more conscious than others, I think, when going through the cancer treatment and you know, and a lot of it was in retrospect writing the book as well, thinking, Well what was I doing there? Actually I was using this skill, yeah.
Paula Redmond (29:02)
Yes. And you describe really beautifully, you know, those, just the importance of being able to be really kind of making space for your feelings, for your emotional response. And that that was something, as you were saying, that the context didn’t really enable for you. That that wasn’t something that the healthcare professionals were offering. You had to, you had to create that for yourself, that sense of noticing, naming, accepting the really strong feelings.
Sarah Swan (29:35)
Yeah. Yeah. And that was in a very conscious way in relation to… I wrote in the book about being very fearful of having a mastectomy and not having a reconstruction immediately. And yeah, I did a good hierarchy of, to approach in order to get comfortable with that. And yeah, very consciously took myself off to look at those drawings or look at those photos of women post mastectomy and just sit with that emotion and explore it and allow it and…
Paula Redmond (30:12)
Yeah. Yeah. ‘Cause there’s also this sense of like a lot of sitting with things during this experience, like, you know, waiting for the diagnosis, the kind of you know, waiting for treatment to start literally sitting while you’re receiving treatment. You know, being a… waiting for results and outcomes and you know, the exhaustion and recovery and that is hard bit, the being with it and no escape.
Sarah Swan (30:44)
Yeah, yeah, exactly. Yeah.
Paula Redmond (30:47.404)
Yeah. What I didn’t read in your book was a kind of sense of like a kind of fighting battle story about cancer. And I wanted to ask you about that ’cause I guess that that’s quite a prevalent narrative around, you know, beating cancer and the battle and I haven’t been through cancer myself, so I don’t know what it’s like when you’re in it, but that’s always kind of uncomfortable for me, that narrative. Because I guess on the one hand I can feel like, you know, being able to tap into kind of courage and strength and, you know, hope and all of that is positive. But on the other hand, I suppose I think about, you know, people who then haven’t survived. And what is that story then?
Sarah Swan (31:43)
Yeah, no, I feel very much the same. Yeah, I mean, you have all these self blaming thoughts, understandably, when you get your diagnosis, you look back, what have I done, you know, to have caused this when largely it’s just bad luck. And so yeah, the idea that whether you get through it depends on how hard you fight it, again just leads to that self blame, doesn’t it? Whereas again it’s largely chance and yeah, yeah, I’d agree. I don’t think I had to draw on courage and follow that as a value and take those really scary steps as I had during that time. So yeah, and I think I was, I talk about journey, I was unsure about that terminology and you know, what you can, you can over analyse these things can’t you and and I know some people don’t like that idea either but for me it seemed to, seemed to fit. It was the word that kept coming to mind so I used that.
Paula Redmond (32:53)
Yeah. We talked about how, you know, having breast cancer impacted you as a clinical psychologist. What about the other way around in terms of how you think being a clinical psychologist impacted your experience with breast cancer? And I guess part of what you’ve been saying is those skills that you have learnt through your work that supported you in coping. Is there anything, any other ways in which…?
Sarah Swan (33:16)
I think the main way was, I think, that ability to notice what I was going through as well as experiencing it. So that noticing self in ACT. You know, I think in the beginning when I received the diagnosis, I think I was quite dissociated. It was more than just a you know a noticing self.I still picture that as I’m looking down on myself sitting in the, across from the doctor kind of thing. But yeah, I think it was that ability to notice what I was, what was coming up in me, the thoughts and feelings I was having at every step of the way. You know, of course at times I was not able to do that and I was, you know, fully in them and yeah, spiralling and yeah, of course. But I think that was probably the most powerful thing that my profession taught me.
Paula Redmond (34:18)
And so, what about your interactions with other health professionals in that context? Because I guess one of your observations, whether that was at the time or or afterwards, was like how they struggled to sit with your distress. And that there’s one instance that you describe about, I think when you were actually given a questionnaire to fill in about your mental health, and that the nurse responding to that was pretty unhelpful. And I wonder whether, you know, you kind of really knew that that was an unhelpful response on a number of levels. Like one was just humanly, that’s not what you were maybe hoping for. But on the other your kind of psychologist’s self was like, whoa, is that really…?
Sarah Swan (35:06)
Yeah, yeah. I think I, you know, I found it really hard being a patient. And you know, of course you’re, you know, aware of NHS processes and, you know, how things should run and, you know, can be quite critical of that. As I said, I was doing this through COVID as well, but, and so actually, you know, and my treatment was not interrupted at all, which was incredible. And yeah, on on the whole I found the staff amazing and really it sort of, the staff on the chemo ward were really good at kind of creating a kind of light environment. And of course because of COVID after my first couple, I think I then wasn’t able to take anyone with me. So that would have been really… I think, I think they said if it was your first one you could take someone with you ’cause I think that would be really tough to do it all on your own. And I think they haven’t gone back to having visitors with people now actually. So that’s been a a lasting change. ‘Cause it was certainly very busy. And that really struck me actually. Gosh, I had no idea that this is going on day after day. And had real admiration for a lot of the health professionals I came across and their warmth and kindness you know, in those moments. And I remember a doctor who I only saw once, I think, but in the beginning, and me sort of expressing some of those thoughts around, you know, what have I done to have caused this? And and and she just placed a hand on my knee, which some people might not feel comfortable with, but that felt okay for me, and she just said, Look, you’ve done your job, you’ve found the lump, you know, let us do our job now. And that was really, I felt she was really engaging with my emotional state at that point. And it felt like I could trust her to sort of carry me from there, if you like. And it’s interesting, you know, often in my career I might be quite challenging of medical perspectives perhaps, but I found that I wanted to place my trust in my doctors. And I know of other people who kind of have gone down the ‘and now I’m gonna do a lot of research myself and I’m gonna really challenge my doctors on this’, and that’s great if you want to go down that route. For me I felt, I just felt well I don’t think I’m gonna be able to search the literature in a way where I’m gonna be confident in the knowledge base that I’ve got and kind of I’ve got enough going on I want to trust that they do know what they’re doing. You know. I did ask questions. I did at one point asking, you know, if I went for a second opinion, would I likely be given a different treatment path? And he was honest in saying, well, because my surgeon didn’t want to do an immediate reconstruction, he said somebody else might do, but this is the reasons why I don’t want to. So I didn’t, I didn’t go for that second opinion. But yes, it was interesting actually that I didn’t challenge as much as I thought I might or didn’t research as much as I thought I might.
Paula Redmond (38:48)
Yeah. and Sarah, what are the key things that you’d like health professionals in particular to take away from this book? So I’m thinking about, you know, other psychologists or health professionals who might themselves going through breast cancer on the one hand, but also those who might be working with or supporting people, you know, whether that’s clients or family members. What would you particularly like people to take?
Sarah Swan (39:17)
I’m just thinking maybe that the things would be the same for both groups actually, that you know just it is really understandable, normal to have all these thoughts and feelings going through this, that those don’t stop at the end of the treatment. It in some respects might only really start then.
Paula Redmond (39:39)
That’s just such an important point. Maybe you can just say more about that? ‘Cause I guess I’m thinking there, I suppose, about from a trauma informed kind of perspective, that I guess it’s only when you’re, you know, feeling a bit safe that that kind of immediate threat has passed that you might be able to process what you’ve been through. And I guess it’s not just the you know, the kind of terror of the illness, but the I guess the treatment can be so traumatic too.
Sarah Swan (40:09)
Yes, exactly. Yes, I think, you know, I was terrified when I got the diagnosis about what the treatment, how the treatment would be. And at times it was worse than I expected and there were things that I didn’t even know about that you know, happened and, you know, were difficult. And so so with the chemotherapy, as I say for me that was every other week. I had a week of feeling really ill and then a week of feeling a bit more normal. So during that week of feeling a bit more normal, I didn’t really want to tap into my emotional state too much because I just needed to get on, I needed to to work, I needed to spend some time with my family, cook some meals ahead for the following week, you know. And it, yeah, things were coming pretty quickly one after the other, you know. Major surgery, then straight into chemo, then straight into radiotherapy, then you know. So yeah, there wasn’t the time and space, there wasn’t a sense of, yeah, as you say, kind of physical safety to be able to stop and go, Wow, what have I just been through?
Paula Redmond (41:25)
Yeah. Yeah. So that feels really important that both what you’re saying in terms of, you know, what is normal and understandable in terms of the emotional impact of this experience, but also that the full impact might only be felt afterwards. I guess you have that image of I don’t know, you know, people ringing the bell when they’ve had their last treatment you see, and sort of as, you know, I mean, you know, wonderful to be through that, but with a recognition that there’s, you know, that’s not the end in terms of processing and the emotional…
Sarah Swan (42:05)
Yeah, yeah. And for your loved ones as well, you know, you’re not the only person going through it and they’ve had to stay strong for you during that period as well and yeah. And children of course will be processing it in different ways and yeah. I know for one of mine it kind of hit him a bit later actually. Yeah.
Paula Redmond (42:27)
Yeah. So Sarah, if people want to we’ll put it in the show notes and things, but if people want to be able to get hold of the book and read it, what’s the best way to do that?
Sarah Swan (42:39)
Yes, so you can get hold of the book on the Sequoia website or on Amazon.
Paula Redmond (42:47)
And Sarah, could you tell us about the rest of the series?
Sarah Swan (42:51)
Yes, it’s been such a pleasure to work on the series as a whole, yeah, and reading everyone’s brilliant books. You know, I was quite pleased with mine when I finished it and then I’ve read everyone else’s and gone, that’s amazing, that’s amazing, this is so amazing. So yeah, we’ve got titles out already on coping with menopause, psoriasis, trauma, endometriosis, bereavement, early parenting, coping with parenting when your child’s neurodivergent, Huntington’s and Functional Neurological Disorder.
Paula Redmond (43:35)
Wow, it’s such, it’s very varied.
Sarah Swan (43:38)
Really varied, such a range of topics which has been great, and there’s a few more still being written as well. So they’re available on the Sequoia website and then the Routledge website because we’ve changed to a different publisher.
Paula Redmond (43:53)
Yeah, and we’ll put all those links in the show notes. If you are an ACP member, there’s a discount code as well. So yeah, brilliant. And I’m really excited too. I think what’s also great is you know, being able to read the books to prepare for this series is also just seeing how they are a bit different from each other, that everyone’s got their own kind of ways, a little bit of a different structure to them that fits their topic. So, yeah, I really recommend them. They’re really lovely books. So yeah, so thank you, Sarah, for bringing your own book, but also kind of supporting all of this great work to be out as well.
Sarah Swan (44:40)
Yes, it’s my pleasure.
Paula Redmond (44:47)
Thank you for listening. If you’ve enjoyed this episode, please support the podcast by sharing it with others, posting about it on social media, or leaving a rating or review. I’d love to connect with you, so do come find me on LinkedIn or at my website. And do check out ACP UK and everything it has to offer. All the links are in the show notes. Thanks again and until next time, take good care.
